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Over the course of the 20th century, the adolescent female athletes became an important participant in the sports environment around the world.1 Women were banned from the first Modern Olympics in 1896, but now make up a significant part of the Olympic games and not infrequently outshine the men. Beyond athletic competition and sporting events, the proven benefits of physical exercise on somatic and mental health are numerous; thus, adolescent females should be encouraged to participate in sport activities. This chapter reviews selected aspects of the adolescent female athletes that include stress urinary incontinence, breast injuries, pregnancy and exercise, menstrual dysfunction, and the female athlete triad Box 9-1. Iron deficiency anemia is increased in female athletes versus males and is discussed in the hematology chapter. An overview of the physiology of the female athletes is considered at this time.

Both male and female children are basically equal in physical condition and have equal parameters as noted in Table 9-1. Male and female children have the same strength before puberty but these changes with the event of puberty. After puberty, females aged 11 to 12 years are 90% as strong as their male counterparts versus 85% as strong at ages 13 to 14 years and 75% at ages 15 to 16 years.1 The specific responses to exercise training do vary from person to person based on willingness to train and genetic factors; however, being a female child or a male child does not influence these responses. There are, of course, individuals in general society who predict that female children are “poor” athletes in contrast to the males, resulting in a cultural attitude that can limit or even exclude the female athlete from training, often compounded by providing her with inferior sports equipment.

The consequences of puberty include an increase in body fat percentages, particularly in females, with an eventual average body fat percentage of 23% to 27% in adult females versus 13% to 15% in adult males.1 Intensive training in adolescent ...